How to Detect Blood in Urine

Medically reviewed by Scott Tobis, MD

Last Updated: March 15, 2023 References

Experts agree that you need to see a doctor right away if you notice blood in your urine, but try not to worry because the cause might be harmless.^{[1]
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Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source} Blood in your urine may mean you have a condition called hematuria. Research suggests that blood in your urine may also be a sign of a condition like a urinary tract infection (UTI), bladder condition, liver disease, or kidney problems.^{[2]
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MedlinePlus
Collection of medical information sourced from the US National Library of Medicine
Go to source} Talk to your doctor if you think you have blood in your urine so you can get treatment if you need it.

Part 1

Part 1 of 3:

Checking Your Urine at Home

1
Inspect the color of your urine. Blood will often make your urine appear to be red, pink or brown (similar in shade to Coca-Cola). After you pee, step back and inspect the color of the urine before you flush the toilet to look for abnormal colors in it.^{[3]
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Scott Tobis, MD
Board Certified Urologist
Expert Interview. 26 August 2021.}^{[4]
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Mayo Clinic
Educational website from one of the world's leading hospitals
Go to source}
- Blood in the urine can also form a clot which can appear dark red, black, or purple in color.^{[5]
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  Scott Tobis, MD
  Board Certified Urologist
  Expert Interview. 26 August 2021.}
- Blood can also at times appear rust-colored, or similar to coffee grounds.^{[6]
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  Expert Source
  
  Scott Tobis, MD
  Board Certified Urologist
  Expert Interview. 26 August 2021.}
- Your urine should be clear or a very light yellow in shade. It should resemble the color of lemon juice from one squeezed lemon.
- If your urine is a dark yellow, it might indicate that you are dehydrated. Increase your water intake to 8 to 10 glasses of water a day in order to have healthier urine.^{[7]
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  Mayo Clinic
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- Dark or orange urine can also be a sign of a problem with your liver, especially if you have light colored stools or yellowing skin. Consult your doctor immediately if this describes your symptoms.^{[8]
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  Mayo Clinic
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- If you've recently eaten beets, your urine may appear pink. Don't let this alarm you as it is not an indication of a medical issue.
2
Assess other symptoms. Blood in the urine can often be a symptom of a problem in your bladder, urinary tract, or kidneys.
- Have you had any pain or irritation when you have used the bathroom recently? Have you had trouble controlling when you urinate or do you experience a burning sensation when you pee? If so, this might be a sign of a urinary tract infection (UTI).
- Have you had any pain in your kidneys? You will generally have felt this in your back. Your kidneys are located under your ribs and on either side of your spine (not on the small of your back or above the buttocks, as commonly perceived). If you have any pain on your back, you might have an inflammation or irritation in the kidneys.^{[9]
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  Mayo Clinic
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- Are you a long distance runner? Blood in the urine has been connected to vigorous exercise, especially marathon runners. In this case, blood in the urine is most likely harmless, but you should still consult your doctor.^{[10]
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- Are you menstruating? Blood in the urine can occur when you use the bathroom during menstruation. While blood in the urine in this case is generally harmless, you should still consult your doctor if your symptoms persist after you finish menstruating.^{[11]
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  National Institute of Diabetes and Digestive and Kidney Diseases
  Health information from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the U.S. National Institutes of Health
  Go to source}
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3
Contact your doctor. If you detect blood in your urine, you should contact your doctor. While there might not be anything wrong with you, blood in the urine is a serious symptom that can only be properly assessed by a medical professional.^{[12]
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Mayo Clinic
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- Start by contacting your general practitioner for an appointment.^{[13]
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  Mayo Clinic
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  Go to source} They will know your medical history and will be able to test for any problems in your urine and blood. It is possible that they will refer you to a specialist (like an urologist) if you need advanced treatment for a particular area of the body or for a specialized condition, like kidney disease.

Part 2

Part 2 of 3:

Visiting Your Doctor

1
Provide a urine sample. Your doctor will most likely want to test your urine, although he or she will also check for other abnormalities, like pain in the kidneys or bladder. The urine sample will help your doctor find the underlying cause of the blood in your urine.^{[14]
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Scott Tobis, MD
Board Certified Urologist
Expert Interview. 26 August 2021.}^{[15]
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National Institute of Diabetes and Digestive and Kidney Diseases
Health information from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the U.S. National Institutes of Health
Go to source}
- The best way to give a urine sample is to get a "mid stream clean catch." Clean your genitals with a safe antiseptic towelette before collecting the sample.^{[16]
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  Expert Source
  
  Scott Tobis, MD
  Board Certified Urologist
  Expert Interview. 26 August 2021.}
- The urine sample is called a urinalysis. If the urinalysis reveals Escherichia coli (E. coli) in the urine, it is likely you are suffering from a bladder infection (or cystitis). The urinalysis may also show bacteria in your gastrointestinal (GI) tract that stems from the anus. In this case, you likely have urethritis, or an infection of the urethra. The urine sample can also detect the presence of any cancerous cells.
- If large amounts of protein are present in the urine, this may be an indication that you suffer from a kidney disease.^{[17]
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  National Institute of Diabetes and Digestive and Kidney Diseases
  Health information from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the U.S. National Institutes of Health
  Go to source}
2
Get your blood tested. Your doctor may decide to also take a blood sample in addition to a urine sample. You will most likely have this taken at your doctor's office, but they may send to a different health care provider or commercial facility that specializes in taking samples. The blood sample is then sent to a lab for analysis.^{[18]
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National Institute of Diabetes and Digestive and Kidney Diseases
Health information from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the U.S. National Institutes of Health
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- Your doctor may analyze a blood sample in order to determine the presence of creatinine, a waste product that is normally filtered out of the blood stream by your kidneys. If you have a high level of creatinine in your blood, this may indicate a problem with your kidneys. ^{[19]
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  National Institute of Diabetes and Digestive and Kidney Diseases
  Health information from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the U.S. National Institutes of Health
  Go to source}
3
Get a biopsy. If your urine sample and blood tests indicate a larger problem in the kidneys, then your doctor may wish to do a biopsy. This is where a small piece of kidney tissue will be removed and examined under a microscope. It's a very common procedure.^{[20]
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Mayo Clinic
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- Local anesthesia will be administered and the doctor will use computerized tomography, or ultrasound, to guide a biopsy needle into your kidney.
- After the tissue is removed, it is examined by a pathologist in a lab. Your doctor will call you in a week or so with the results and to discuss what treatment is necessary, if any.
4
Explore more advanced testing. It is likely your doctor will have a diagnosis prepared for you after analyzing the blood and urine samples. But if not, he or she may want to conduct further tests, such as a cystoscopy or take an imaging test of your kidneys.
- The cystoscopy is a more invasive procedure than a biopsy. A tubular instrument will be inserted into your bladder and urethra to look for any abnormal growth or tumors in the area.^{[21]
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  National Institute of Diabetes and Digestive and Kidney Diseases
  Health information from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the U.S. National Institutes of Health
  Go to source}
- X-rays of your urinary tract will also reveal any mass growth or tumors that might be blocking responsible for blood in your urine. Your doctor will generally only require these if the cause of the blood is unclear from earlier tests.
5
Complete your prescribed treatment. The treatment for blood in the urine will vary depending on its underlying cause. If you have a UTI, your doctor will prescribe a course of antibiotics (usually in pill/capsule form, taken once or twice a day). If you have kidney stones, you might be given a round of shock wave therapy. ^{[22]
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Mayo Clinic
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- It is also possible that your doctor will find no serious, underlying cause of blood in the urine. In this case, you might not be prescribed any treatment, but you should be vigilant of any reoccurrence of hematuria.

Part 3

Part 3 of 3:

Understanding the Causes of Hematuria

1
Research the causes of hematuria. Hematuria can be caused by any number of conditions, some harmless, some more serious. In more benign cases, it can be caused by menstruation or excessive exercise (especially when you become dehydrated).^{[23]
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Mayo Clinic
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Go to source}. But its more serious causes can include the following:
- A UTI
- Blood clots or clotting conditions, such as hemophilia
- Kidney stones
- Kidney disease or diabetes
- An enlarged prostate
- Trauma or injury to the kidney
- Kidney, bladder or prostate cancer^{[24]
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  National Institute of Diabetes and Digestive and Kidney Diseases
  Health information from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the U.S. National Institutes of Health
  Go to source}
2
Beware of invisible symptoms. There are actually two forms of hematuria: gross and microscopic. In gross hematuria, you will be able visibly spot the blood in your urine through the pink, red or brown discoloration. But if you suffer from microscopic hematuria, you will not be able to visibly detect any blood in the urine.
- If you have a history of kidney, bladder or prostate cancer in your family, be sure to have your doctor test your urine at your annual check-up, especially if you are over the age of 40. Microscopic hematuria might be a symptom of a larger problem in your urinary tract, but it can only detected through testing.^{[25]
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  Trustworthy Source
  National Institute of Diabetes and Digestive and Kidney Diseases
  Health information from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the U.S. National Institutes of Health
  Go to source}
3
Prevent re-occurrences of hematuria. While the specific steps for prevention will vary depending on the cause of the blood in the urine, there are some general measures you can take to prevent a reoccurrence.
- If your hematuria is caused by a UTI, then drink plenty of liquids (8-10 glasses of water a day) to stay well hydrated. If you are a woman, be sure to wipe from front to back when you use the bathroom so you won't get bacteria from the anus into your urinary tract.
- If your hematuria is caused by kidney stones, drink lots of water and avoid foods that are high in salt.^{[26]
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  Trustworthy Source
  National Institute of Diabetes and Digestive and Kidney Diseases
  Health information from the National Institute of Diabetes and Digestive and Kidney Diseases, a division of the U.S. National Institutes of Health
  Go to source}
- If your hematuria is caused by cancer in either the bladder or the kidney, then be sure to drink lots of fluids, eat a healthy diet of lean meats and vegetables, and stop smoking. Light to moderate exercise will also be a good preventative measure.

Expert Q&A

Question

When should I worry about blood in urine?

Scott Tobis, MD
Board Certified Urologist
Dr. Scott Tobis is a board certified Urologist. With more than seven years of experience, he specializes in treating patients for urologic conditions such as urologic cancers, prostate enlargement, vasectomy, kidney stones, frequent/urgent urination, erectile dysfunction, incontinence, and blood in the urine. Dr. Tobis holds a BS in Cellular and Developmental Biology from The University of California, Santa Barbara, and an MD from Dartmouth Medical School. He completed his internship in General Surgery and residency in Urologic Surgery at the University of Rochester School of Medicine and Dentistry and his fellowship in Urologic Oncology and Robotic Surgery at The City of Hope National Medical Center. Dr. Tobis is a diplomat of the American Board of Urology.

Scott Tobis, MD

Board Certified Urologist

Expert Answer

The most common indication that there is blood in the urine is to have it found microscopically on a urine test. This would not be visible to the naked eye. This is relatively common and is often not a problem. However, if present you, should discuss with your doctor if a workup is indicated.
Question

Why is there blood in my urine when I'm pregnant?

Lacy Windham, MD
Board Certified Obstetrician & Gynecologist
Lacy Windham, MD, is a Board-Certified Obstetrician & Gynecologist in Cleveland, Tennessee. Dr. Windham attended medical school at the University of Tennessee Health Science Center in Memphis. Her residency was completed at Eastern Virginia Medical School in Norfolk, Virginia. She was the recipient of multiple awards during her residency training, including Most Outstanding Resident in Maternal Fetal Medicine, Most Outstanding Resident in Oncology, Most Outstanding Resident Overall, and Special Award in Minimally Invasive Surgery.

Lacy Windham, MD

Board Certified Obstetrician & Gynecologist

Expert Answer

Blood in the urine can be a sign of urinary tract infection or kidney stone. It can also be mistaken for vaginal bleeding. It should be evaluated.